Trial of Maintenance Therapy in Schizophrenia

A double-blind, placebo-controlled trial was carried out to determine the value of maintenance therapy with phenothiazines in a population of outpatients who had recently recovered from an acute episode of schizophrenia. The drug was shown to be significantly more effective than the placebo in preventing relapse. The relationship of the trial patients to the population from which they were selected was defined in terms of clinical, historical, and social data. Maintenance therapy seems of little value in patients with a good prognosis and in the severely ill, but it is of value in the indeterminate group between these two extremes.     

Outpatient Maintenance of Chronic Schizophrenic Patients with Long-acting Fluphenazine: Double-blind Placebo

A double-blind placebo trial of fluphenazine decanoate, a long-acting phenothiazine, was carried out to determine its value in maintenance therapy of chronic schizophrenic outpatients already established on the drug for a minimum period of eight weeks. In low doses it was significantly more effective than placebo in preventing relapse and admission to hospital. Relapse was accompanied by a resurgence of specifically schizophrenic symptoms and by an increase in abnormalities described by the relatives. There was no difference between the experimental and control groups in the treatment required for depression. The group on active medication required more treatment for Parkinsonism, but this difference did not reach statistical significance.In the context of a well-run special clinic for outpatient follow-up of chronic schizophrenic patients these results confirm the usefulness of long-acting fluphenazine. By inference, the benefit of this treatment highlights the need for adequate community services to deal with the residual chronic disabilities which are characteristic of these patients.     

Dog-Assisted Therapy in the Treatment of Chronic Schizophrenia Inpatients

ABSTRACT

Patients with a diagnosis of schizophrenia living in long-term care units show high levels of disability. The present study aimed to assess the effectiveness of including a trained therapy dog in an intervention program applied to institutionalized patients with chronic schizophrenia. A randomized, controlled study with blind assessment was conducted. Twenty-four persons with chronic schizophrenia were randomly selected from a register that included all inpatients at Saint John of God's psychiatric hospital in Spain. Patients who agreed to participate (n = 21) were randomly assigned to one of the two treatment groups: one group received an intervention assisted by a therapy dog (IG+D) (12 patients), while the other received the same intervention but without a therapy dog (IG) (9 patients). The assessment items included the Positive and Negative Symptoms Scale (PANSS), the Living Skills Profile (LSP), the Brief World Health Organization Quality of Life Assessment (WHOQOL-BREF), and the Satisfaction with Treatment Questionnaire (STQ). Mann Whitney U tests and Wilcoxon signed-rank tests were conducted. Patients in the IG+D group showed significant improvements in the LSP social contact score (p = 0.041), in the positive (p = 0.005) and negative symptom dimensions (p = 0.005) and total score of the PANSS (p = 0.014), and in quality of life related with social relationships (p = 0.024). Patients in the IG group showed significant positive changes in positive (p = 0.027) and general symptoms (p = 0.046) and total PANSS score (p = 0.027). No differences were found between the two groups before and after the application of the intervention. Introducing a dog into the psychosocial intervention for patients with schizophrenia produced some positive outcomes. However, the results of the study are not conclusive and must be interpreted cautiously.     

Resveratrol Protects Against Vacuous Chewing Movements Induced by Chronic Treatment with Fluphenazine

Typical antipsychotics, which are commonly used to treat schizophrenia, cause motor disorders such as tardive dyskinesia (TD) in humans and orofacial dyskinesia (OD) in rodents. The disease mechanisms as well as treatment effectiveness are still unknown. In this study, we investigated the effect of resveratrol, a polyphenol with neuroprotective properties, on behavioral changes induced by chronic treatment with fluphenazine in rats and the possible relationship between monoamine oxidase (MAO) activity and vacuous chewing movements (VCMs). Rats were treated for 18 weeks with fluphenazine enantate [25 mg/kg, intramuscularly (i.m.), every 21 days] and/or resveratrol (20 mg/kg, offered daily in drinking water). Next, body weight gain, behavioral parameters (VCMs and open field tests—locomotor and rearing activity), and MAO activity were evaluated. Fluphenazine treatment reduced body weight gain, number of crossings and rearings, and the co-treatment with resveratrol did not affect these alterations. Fluphenazine increased the prevalence and intensity of VCMs and the co-treatment with resveratrol reduced the VCMs. Furthermore, a negative correlation was found between the number of VCMs and MAO-B activity in the striatum of rats. Our data suggest that resveratrol could be promissory to decrease OD. Moreover, MAO-B activity in the striatum seems to be related to VCMs intensity.